Centene Corporation logo
Centene Corporation

Transforming the health of the communities we serve, one person at a time.

Supervisory Medical Director, Inpatient UM & Appeals

Medical DirectorMedical DirectorFull TimeRemoteLeadTeam 10,001+Since 1984H1B No SponsorCompany SiteLinkedIn

Location

Missouri

Posted

72 days ago

Salary

$236.5K - $449.3K / year

Seniority

Lead

Postgraduate Degree5 yrs expEnglish

Job Description

• Provide people leadership, coaching and mentorship for a team of front-line medical directors • Support Chief Medical Officer in the execution of strategic clinical initiatives • Participate in utilization review studies, evaluate adverse trends; and collaborate with CMO to develop solutions • Handle complex and high-profile utilization management cases • Conduct regular rounds to assess and coordinate care for high-risk patients • Oversee and actively participate in the appeals process • Collaborate closely with clinical teams, appeals team, and network providers to ensure understanding and adherence to utilization management policies

Job Requirements

  • Medical Doctor (MD)
  • Graduate of an accredited medical school required
  • Master's Degree MBA, MPH, preferred
  • 5+ years Managed care/ clinical experience; experienced with commercial, Medicare and Medicaid lines of business required
  • 1+ years Supervisory/management experience preferred
  • Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services required
  • Certification in Internal or Family Medicine specialty preferred
  • Current state license as a MD or DO without restrictions, limitations, or sanctions from government programs required

Benefits

  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • flexible approach to work with remote, hybrid, field or office work schedules

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